THE ASSOCIATION OF A NOVEL PHYSICAL ACTIVITY METRIC WITH COGNITION AND RISK OF DEMENTIA

Abstract Physical activity (PA) is associated with cognitive function and Alzheimer’s disease and related dementias (ADRD). Although associations between continuously measured PA and ADRD have been assessed, multiscale entropy (MSE), which quantifies dynamics of physiological systems over multiple time scales, has not been used to quantify daily activity rhythms in older adults by cognitive status. We examined the association of this novel metric of PA complexity with cognitive function, mild cognitive impairment (MCI), and dementia in participants of the Baltimore Longitudinal Study of Aging. A total of 615 older adults (mean age=73.9±11.3 years, 54.5% women) completed a 7-day wrist-worn accelerometer assessment between 2015-2019. Global cognitive function was measured using the Mini-Mental State Examination (MMSE). Mild cognitive impairment (MCI) or dementia was diagnosed based on Petersen criteria and Diagnostic and Statistical Manual of Mental Disorders, respectively. Unadjusted logistic regression models showed that participants in the lowest tertile of complexity had 2.31 times the odds of low MMSE score (≤26) compared to those in the highest tertile (odds ratio [OR]=2.31, 95% confidence interval [CI]=1.09-4.89). This association lost significance after adjusting for age, sex, race, and education years. The lowest tertile of complexity was also associated with 2.58 times the odds of MCI/dementia diagnosis, adjusting for demographics (OR=2.58, 95% CI=1.06-6.31). These results suggest that lower complexity of accelerometry-detected movement is associated with poorer cognitive function and greater risk of MCI/dementia. Future longitudinal studies are warranted to examine whether altered complexity of daily activity rhythms may act as a preclinical indicator of ADRD.

exploratory risk factors identified at mid-( < 65 years) and late-life (65+ years).A total of 261,116 individuals (59.3% female; mean age at index date [SD]: 82.70 [8.54]) with and without dementia were included.Compared with the logistic model (area under the curve [AUC]: 0.60), the predictive and diagnostic accuracy of dementia improved substantially in machine learning models.The Multilayer perceptron and LightGBM models showed comparable performance with the same test AUC of 0.720.LASSO (AUC: 0.765) and Random Forest (AUC: 0.768) showed a slightly worse performance.Antipsychotic drugs, education, antidepressants and head injury in late life were the top 4 important predictors in all models.The machine learning-based algorithm for predicting dementia can be used to identify patients with an increased likelihood of dementia to allow precise and timely primary interventions.Evidence is accumulating that individuals with cancer diagnoses exhibit Alzheimer's disease (AD) and related dementia (ADRD) risk profiles that differ from the general population of U.S. older adults.In this study we used SEER-Medicare data to compare the relative risk of AD/ADRD between individuals with slow-progressive cancers and the non-cancer general population.The study cohort included individuals age 65+ (N=2,023,054) with a primary diagnosis (1999-2017) of one of nine slow progressive cancers (breast, colorectal, prostate, uterine, kidney, ovarian, and urinary bladder cancers, as well as lymphomas and melanoma) and no clinical record of AD/ADRD prior to cancer diagnosis.This cohort was then matched by age to a comparable non-cancer population (N=1,142,641).The hazard ratios of AD/ADRD for each cancer compared to the noncancer cohort were evaluated individually in 29 age-specific groups for each cancer type.All cancers had similar patterns of dependence for post-cancer AD/ADRD risks.We found that the presence of cancer was associated with higher risk of AD/ADRD at age at diagnosis 65-75; the relative risks decline with age at diagnoses becoming protective at advanced ages.Furthermore, for any given age at diagnosis the relative risk of AD/ADRD (i.e., cancer vs. non-cancer) also declines with time.Detailed discussion of possible causes of these effects including cancer treatment, genetic variation, possible trade-off effects, common risk and protective factors, possibly lower administration and adherence of AD/ADRD diagnostic procedures for individuals with cancer, and the roles of competing risks (first of all due to death cases) is presented.

THE ASSOCIATION OF A NOVEL PHYSICAL ACTIVITY METRIC WITH COGNITION AND RISK OF DEMENTIA
Yurun Cai 1 , Junhong Zhou 2 , Qu Tian 3 , Amal Wanigatunga  09-4.89).This association lost significance after adjusting for age, sex, race, and education years.The lowest tertile of complexity was also associated with 2.58 times the odds of MCI/dementia diagnosis, adjusting for demographics (OR=2.58,95% CI=1.06-6.31).These results suggest that lower complexity of accelerometry-detected movement is associated with poorer cognitive function and greater risk of MCI/dementia.Future longitudinal studies are warranted to examine whether altered complexity of daily activity rhythms may act as a preclinical indicator of ADRD.

THE RELATIONSHIP BETWEEN 10-YEAR CHANGES IN COGNITIVE ABILITY AND SUBSEQUENT MORTALITY: FINDINGS FROM THE ACTIVE
Diefei Chen 1 , Alden Gross 2 , Sherry Willis 3 , and George Rebok 4 , 1. Johns Hopkins, Baltimore, Maryland, United States,2. Johns Hopkins University Bloomberg School of Public Health,Baltimore,Maryland,United States,3. University of Washington,Seattle,Washington,United States,4. Johns Hopkins University,Baltimore,Maryland,United States Cognitive ability and cognitive decline have been linked with mortality in older adults.However, little was understood about the role of cognitive interventions on mortality outcomes in this population.Using twenty-year follow-up data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, we examined the association between cognitive change and mortality risk, and the effect of ACTIVE cognitive training (memory, reasoning, and speed of processing) on mortality risk.Mortality was ascertained through linkage to the National Death Index database.To model time to death as a function of cognitive change and training effect, we used shared growth-survival models with simultaneously estimated latent intercepts and slopes as predictors.Among the 2802 participants, 2021 died on or before the year 2019 (72.1%).Both higher baseline level and slower decline in global cognition were associated with lower hazards of all-cause mortality after adjusting for covariates (HR = 0.68, 95% CI 0.58, 0.79; HR = 0.42, 95% CI 0.40, 0.44, respectively).We did not observe any significant effects of ACTIVE cognitive training in memory, reasoning, or speed of processing on all-cause mortality.Our findings demonstrated the association between the trajectory of cognitive change and mortality among older adults, independent of cognitive training interventions.More work is needed to identify relevant timing as well as modalities of non-pharmaceutical interventions that can promote healthy longevity.

SOCIAL AND TECHNOLOGICAL SUPPORTS FOR AGING
Abstract citation ID: igad104.1298

AGE AND COHORT TRENDS OF RACIAL/ETHNIC DIFFERENCE IN RELIGIOUS PARTICIPATION AMONG MIDDLE-AGED AND OLDER AMERICANS Jingwen Liu, University of Maryland, College Park, College Park, Maryland, United States
Religious involvement is an important way of maintaining social connectedness for older Americans.While large quantities of studies have explored age and cohort effects of religious participation separately, less is known about racial/ethnic disparities.Applying growth curve modeling to the 2004-2020 waves of the Health and Retirement Study (N=134,734 person-years), the current study examines how religious attendance changes across the life course and among recent birth cohorts, as well as how exposure to immigration policy regimes (IPR) shapes Hispanic immigrants' religious participation behaviors.Results suggest an overall reversed U-shape age trajectory with lower average levels and faster declines among more recent cohorts.Compared to White older adults, Black and Hispanic populations attend religious activities more frequently, but their attendance declines at faster rates in later life, leading to minimal White-Nonwhite differences in the oldest ages.However, Hispanic immigrants display significantly less decline in religious participation among more recent cohorts relative to Whites, although no similar trend is found between White and Black/native Hispanic older adults.Further analyses of Mexican Hispanic immigrants suggest that longer exposure to restricted IPR (since the Immigration Reform and Control Act of 1986, IRCA) is associated with increased religious attendance, but less restricted IPR (between 1964 and 1985) is associated with decreased religious participation net of age and cohort effects.These findings emphasize the importance of understanding the civic engagement experiences of Hispanic immigrants against the context of immigration policy regimes.
4, Eleanor Simonsick 3 , Susan Resnick 3 , Luigi Ferrucci 3 , and Jennifer Schrack 5 , 1. University ofPittsburgh, Pittsburgh,  Pennsylvania, United States, 2. Harvard Medical School/  Hebrew SeniorLife, Roslindale, Massachusetts, United  States, 3. National Institute on Aging, National Institutes  of Health, Baltimore, Maryland, United States, 4. Johns  Hopkins School of Public Health, Baltimore, Maryland,  United States, 5. Johns Hopkins University, Baltimore,  Maryland, United StatesPhysical activity (PA) is associated with cognitive function and Alzheimer's disease and related dementias (ADRD).Although associations between continuously measured PA and ADRD have been assessed, multiscale entropy (MSE), which quantifies dynamics of physiological systems over multiple time scales, has not been used to quantify daily activity rhythms in older adults by cognitive status.We examined the association of this novel metric of PA complexity with cognitive function, mild cognitive impairment (MCI), and dementia in participants of the Baltimore Longitudinal Study of Aging.A total of 615 older adults (mean age=73.9±11.3years, 54.5% women) completed a 7-day wrist-worn accelerometer assessment between 2015-2019.Global cognitive function was measured using the Mini-Mental State Examination (MMSE).Mild cognitive impairment (MCI) or dementia was diagnosed based on Petersen criteria and Diagnostic and Statistical Manual of Mental Disorders, respectively.Unadjusted logistic regression models showed that participants in the lowest tertile of complexity had 2.31 times the odds of low MMSE score (≤26) compared to those in the highest tertile (odds ratio [OR]=2.31,95% confidence interval [CI]=1.